S02 - Attachment 3 _ Past Performance References.pdf

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Attached to
36C25626Q0231 Medical Physicist and Radiation Safety Officer Services
Solicitation number
36C25626Q0231
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Attachment 3 D.3 is an Experience Reference form for a Registered Nurse Services contract (Solicitation Number 36C25623Q0090). The document provides a template for contractors to document three separate reference projects, with fields for capturing detailed information about previous contract performances. Each reference section requires details such as the organization name, address, contract number, brief description of work, contractor role (prime or sub), dates of performance, total contract cost, termination status, and point of contact information. The form is designed to allow potential contractors to demonstrate their past performance and experience in delivering registered nurse services to government or commercial organizations.

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ATTACHMENT 3 D.3 EXPERIENCE REFERENCE

– 36C25623Q0090 Registered Nurse Services

Experience References

REFERENCE 1:

Name of Government or Commercial Organization: Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 2:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

REFERENCE 3:

Name of Government or Commercial Organization:

Address:

Contract Number:

Brief Description:

Contractor Performed as:

Prime Contractor

Sub-Contractor

Dates of Performance (if current include expiration):

Total Cost of Contract: Award/Incentive/Deduction Any terminations for cause or default? Circle YES or NO If yes, brief explanation:

Point Of Contact/COR:

Title:

Telephone Number:

Point of Contact’s email address:

Comments:

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